Friday, May 06, 2011

Libya: Providing medical and surgical treatment to the wounded in Misrata

Source: Medecins Sans Frontieres

Even as the bombings continue, Medecins Sans Frontieres teams are ramping up their medical activities and have been performing surgeries in the northern part of the besieged city of Misrata.

For the past two months, government forces and insurgents have been battling over the city of Misrata. The city continues to be the target of bombings, and insecurity prevents the population from accessing medical care. There is a lack of health professionals, safe places where pregnant women can deliver, and hospital beds for the injured. In Misrata, the 22-member MSF team delivers medical and surgical care to the wounded in two hospitals, Abbad and Kasr Ahmed, and in the Ras Thuba clinic.

Lack of staff

Access to medical care has become more restricted because a large number of medical structures have been destroyed or are located too close to the front lines. In the few medical structures that remain operational, sufficient human resources needed to provide postoperative care, such as orthopaedic surgeons, are simply not available.

“The Libyan medical staff who have been working around the clock for the past seven weeks are exhausted,” explains Mego Terzian, head of emergency operations for MSF. “Moreover, the few medical structures that are still open are without nurses, as most were foreigners who have now left the hospitals.”

On April 28, a nine-person MSF team – two surgeons, two anaesthetists, three nurses, one doctor and one logistician – arrived to lend support to the three-person team that had been in Misrata for 10 days assessing needs.

Surgical operations and rehabilitation of the health structures

The few health structures that are still operating in Misrata have a critical lack of beds, with only around 100 for the entire city.

An MSF surgical team is providing support to the Abbad hospital in the northern part of the city. In the past 48 hours, 10 critical surgeries have been performed.

MSF is also active in the Kasr Ahmed hospital, located in the eastern part of the city. Some 300,000 people have come to the area seeking refuge from the fighting that has been raging in the western part of the city. The team is rehabilitating the operating room and is increasing the structure’s current intake capacity of 12 beds to approximately 50 beds.

“Libyan doctors are forced to send patients back home after just two days, even when their conditions have not been completely stabilised, because they fear not being able to handle a major influx of wounded and the simple lack of human resources,” adds Terzian.

MSF also has a presence at the Ras Thuba clinic, helping mothers give birth, performing caesareans and improving the patient flow. To meet the demand, the MSF teams plan to increase operating room capacity to 50 to 60 beds. An MSF psychologist is also providing mental health treatment to Libyan medical personnel who have been working in harsh conditions, exposed to unrelenting stress since the conflict began.

Supplies running low

In Misrata, water has been in increasingly short supply, with frequent outages and virtually non-stop bombings. In response to the lack of drugs, especially anaesthetics, and the lack of medical equipment, such as masks and respiratory filters, MSF has already sent over 25 tonnes of medical equipment and medications.

In Misrata since April 18, MSF is currently the only independent international medical organisation in the city. During the first half of April, MSF carried out two medical evacuations by boat, referring more than one hundred wounded in Tunisia.

MSF Activities in Zintan

In Zintan, a town near the border with Tunisia, an MSF team has been working with the staff of the town’s hospital since April 30. In recent days, 30 injured have been taken into the hospital, where MSF has been assisting the emergency department, triaging patients and training medical staff. MSF has also deployed mobile clinics along the Tunisian border, focusing on medical and psychological activities.